A little-known terror of the psychiatric inpatient system is the medication queue.
Imagine a group of mentally unwell people arriving at an inadequate row of plastic chairs in no particular order to wait for their personal medications to be dispensed through one of three glass windows, as the patients step up to a window, in order of arrival. Can anyone else see a problem with this?
It’s actually quite amazing that the ‘system’, such as it is, works so well. In all my hospitalizations, I’ve only ever seen or heard two blow-ups at medication time related to the queue system.
I’d better define some terms first. I’m talking about adult wards in private psychiatric clinics in Australia. All admissions are voluntary, and patients with more extreme problems are either in an intensive care unit or at a different type of hospital which can cater to their needs.
Some people take the medications queue in their stride, but I once brought it up in group therapy, and there was a general agreement that it’s a fairly stressful situation (all bar one extroverted and highly confident patient who couldn’t see what we were going on about). Because people arrive in dribs and drabs, there’s no order to the queue – so somehow you must remember who was there before you. I do it by counting heads. The problem with my method is that it doesn’t identify who’s still waiting, so if, say, the person immediately ahead of you in the queue forgets their place, there’s this awkward holdup while everyone says: “Were you next?” “Not me, I think it was you.” “Who, me?” [Yes, you. Just go to the window and get your fucking meds so the rest of us can move along.]
During the group therapy session in which I raised the topic, one brave soul suggested numbering the seats from left to right, and having people sit down in order and move along. A few problems were identified:
a) people are always being admitted to and discharged from the ward, so the new-though-sensible rules would need to be continually explained
b) some people bring knitting or other craft projects to keep them occupied while they wait, and won’t want to move seats
c) for some reason, no matter which hospital it is, there never seem to be sufficient seats
d) come on, we’re talking psych patients here! Are they really going to follow the rules?
Look, perhaps it’s just my anxiety talking, but it seems a minor miracle that the medication queue works at all. As a psychiatrist said to me once, with all these unwell people living in close quarters, it’s amazing we don’t have more disruptions.
Do you have a psych hospital bugbear? A story of systems which somehow hang together?